肥胖对老年高血压患者血压变异性和一氧化氮及内皮素的影响  

Effect of obesity on blood pressure variation and plasma levels of nitric oxide and endothelin in elderly hypertensive patients

作　　者：吴泽兵 张颖 余其贵 孙彩霞 杨琳琳 陶存武 

机构地区：[1]安徽医科大学第三附属医院合肥市第一人民医院老年病科,230061 [2]安徽医科大学第三附属医院合肥市第一人民医院核医学科,230061

出　　处：《中华老年医学杂志》2015年第4期369-373,共5页Chinese Journal of Geriatrics

基　　金：合肥市科研计划项目（200926）;安徽省“十二五”省临床医学重点培育专科资助

摘　　要：目的 探讨肥胖对老年高血压患者血压变异和及血浆一氧化氮、内皮素的影响.方法 选取175例老年高血压患者,根据体质指数分为正常体质量组（69例）、超体质量组（56例）、肥胖组（50例）,监测24 h动态血压、一氧化氮、内皮素水平.结果 3组24 h、日间（6：00～22：00）、夜间（22：01～5：59）收缩压与24 h、夜间舒张压差异无统计学意义（均P＞0.05）;肥胖组晨峰收缩压较正常体质量组、超体质量组升高（均P＜0.05）;肥胖组晨峰舒张压较正常体质量组升高（P＜0.05）;肥胖组日间舒张压较超体质量组升高（P＜0.05）.肥胖组24 h收缩压变异性、日间收缩压变异性、昼夜节律分别为（12.6±2.7）％、（12.2±2.9）％、（5.2±10.5）％,与超体质量组（10.4±2.2）％、（10.2±2.2）％、（1.4±6.9）％和正常体质量组（9.4±1.9）％、（9.2±2.1）％、（1.8±8.2）％比较,差异有统计学意义（P＜0.05或P＜0.01）;肥胖组夜间收缩压变异性、24 h舒张压变异性、日间舒张压变异性分别为（9.8±3.7）％、（15.3±3.3）％、（14.7±3.7）％,与正常体质量组（8.2±3.1）％、（13.2±4.2）％、（12.9±3.8）％比较,差异有统计学意义（均P＜0.05）;各组夜间舒张压变异性差异无统计学意义（均P＞0.05）.肥胖组一氧化氮较超体质量组、正常体质量组降低[（29.8±14.2）μmol/L比（47.9±18.6）μmol/L、（94.6±42.9）μmol/L,P＜0.01],肥胖组内皮素较超体质量组、正常体质量组升高[（46.5±9.8）ng/L比（37.3±4.8） ng/L、（31.1±5.5） ng/L,P＜0.01].在正常体质量组,24 h收缩压变异性与一氧化氮相关（r=0.340,P=0.004）.结论 肥胖导致老年高血压患者血压变异性和内皮素升高、一氧化氮降低,是影响血压变异性、内皮素及一氧化氮的重要因素之一.Objective To investigate the effects of obesity on blood pressure variation and plasma levels of nitric oxide （NO） and endothelin （ET） in elderly hypertensive patients.Methods A total of 175 elderly patients with hypertension were screened for this study.Based on body mass index,they were categorized into three groups with normal weight （n =69）,overweight （n=56） and obesity （n=50）.24 hour dynamic blood pressure,NO and ET levels were monitored.Results No significant differences in 24 h systolic blood pressure,daytime systolic blood pressure,nighttime systolic blood pressure,24 hours diastolic blood pressure （24 h-DBP） and night time diastolic blood pressure were found among the groups （all P〉0.05）.Morning systolic and diastolic blood pressure were higher in obese group than in normal weight and overweight groups（both P〈0.05）.The daytime diastolic blood pressure was higher in obese group than in overweight group.24 h systolic blood pressure variation,daytime systolic blood pressure variation,and blood pressure pattern were higher in obese group than in overweight and normal weight group [（12.6 ± 2.7）% vs.（10.4 ±2.2）% and （9.4±1.9）%,（12.2±2.9）% vs.（10.2±2.2）% and （9.2±2.1）%,（5.2±10.5）%vs.（1.4± 6.9） % and （1.8 ± 8.2） % group,all P〈 0.05].The nighttime systolic blood pressure variation,24 h diastolic blood pressure variation,daytime diastolic blood pressure variation were increased in obese group as compared with normal weight group [（9.8 ± 3.7）% vs.（8.2 ± 3.1）%,（15.3±3.3）% vs.（13.2±4.2）%,（14.7±3.7）% vs.（12.9±3.8）%,all P〈0.05].No differences were found in nighttime diastolic blood pressure variation among the groups.Plasma NO level was lower in obese group than in overweight and normal weight group [（29.8± 14.2）μmol/L vs.（47.9± 18.6） μmol/L and （94.6 ± 42.9） μmol/L,P〈0.01].Plasma ET level was significantly higher in obese group than in overweight group and normal weight group [（46.5�

关 键 词：肥胖症 高血压 一氧化氮 

分 类 号：R544.1[医药卫生—心血管疾病]